Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study

Yuliang Chen; Zhien Zhou; Yi Zhou; Zhipeng Mai; Shijie Jin; Zhen Liang; Zhiyuan Shang; Yuzhi Zuo; Yu Xiao; Wenze Wang; Haibo Wang; Weigang Yan

doi:10.1016/j.xinn.2023.100558

The Innovation > 2024 Vol. 5 > No. 1

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Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study

1.
Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
2.
Department of Gynaecology and Obstetrics, Beijing Hospital, National Centre of Gerontology, Beijing 100730, China
3.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
4.
Peking University Clinical Research Institute, Peking University First Hospital, Beijing 100034, China

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⁵These authors contributed equally
Corresponding author: yanweigang@pumch.cn
Received Date: August 03, 2023

Accepted Date: December 08, 2023

Published Online: January 02, 2024

The Innovation 5(1), https://doi.org/10.1016/j.xinn.2023.100558 | Cite this article

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PUBLIC SUMMARY
1. ■ We conducted prostate autopsies to investigate latent cancer epidemiology and measure the accuracy of prostate biopsy.
2. ■ In recent decades, the prevalence of latent prostate cancer has increased in China.
3. ■ Transperineal and transrectal biopsies exhibited similar sensitivities but different preferential areas.
4. ■ Both methods of biopsy missed one-third of cases with large lesions, most of which were in the anterior prostate.

ABSTRACT

ABSTRACT

Prostate cancer detected by autopsy is named latent prostate cancer. As the repertoire of clinical prostate cancer, latent cancer may better reflect the disease burden. Unlike clinical prostate specimens, which are obtained exclusively from biopsy-positive cases, prostate specimens obtained through autopsy provide information on biopsy-negative cases, helping calculate the true sensitivity of prostate biopsy. From 2014 to 2021, we collected autopsy specimens of the prostate from body donors in China and performed transperineal and transrectal biopsies on specimens before step-sectioning and pathological measurements. We found that the crude prevalence of latent prostate cancer in middle-aged and elderly men was 35.1% (81/231), which was higher than previous estimates for Chinese populations. The overall per-patient sensitivities of transperineal and transrectal biopsies were not significantly different (33.3% vs. 32.1%, p = 0.82), but the two approaches differed in preferential sampling area along the proximal-distal axis of the prostate. Transperineal biopsy had a higher sensitivity for detecting clinically significant lesions in the distal third (34.7% vs. 16.3%, p = 0.02) and distal half (30.6% vs. 18.1%, p = 0.04), while transrectal biopsy had a higher sensitivity for lesions in the proximal half (25.0% vs. 13.9%, p = 0.046). Both transperineal and transrectal methods of biopsy missed most small lesions (< 0.1 mL) and 35.3% (6/17) of large lesions (> 0.5 mL). In conclusion, the prevalence of latent prostate cancer in China has increased over the past 2 decades. Systematic transperineal and transrectal methods of biopsy had comparable sensitivities but had different preferential sampling areas. Both approaches miss one-third of large lesions.

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Yuliang Chen, Zhien Zhou, Yi Zhou, Zhipeng Mai, Shijie Jin, Zhen Liang, Zhiyuan Shang, Yuzhi Zuo, Yu Xiao, Wenze Wang, Haibo Wang, Weigang Yan. Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study[J]. The Innovation, 2024, 5(1). https://doi.org/10.1016/j.xinn.2023.100558

Yuliang Chen, Zhien Zhou, Yi Zhou, Zhipeng Mai, Shijie Jin, Zhen Liang, Zhiyuan Shang, Yuzhi Zuo, Yu Xiao, Wenze Wang, Haibo Wang, Weigang Yan. Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study[J]. The Innovation, 2024, 5(1). https://doi.org/10.1016/j.xinn.2023.100558

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Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study

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Updated prevalence of latent prostate cancer in Chinese population and comparison of biopsy results: An autopsy-based study

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